An International Approach to Mainstreaming Midwifery in America

by Peter Johnson, CNM, PhD, FACNM

As we celebrate Midwifery Week—a time to recognize our profession and celebrate our achievements—I am struck by the good work midwives are accomplishing globally. National Public Radio aired a story last week that highlighted the work of my organization, Jhpiego, that is taking place in the far northern region of Afghanistan. While listening to Renee Montagne’s interview with a young Jhpiego-trained midwife, I felt proud, but it also reminded me of the work left to be accomplished both around the world and here in the United States.

Jhpiego, which serves to “innovate to save lives of women and their families,” has been doing creative work for nearly 37 years and has always maintained close ties to ACNM. Our nearly 800 midwives, nurses, physicians, and public health professionals strengthen midwifery education in war-ravaged countries like Afghanistan and Liberia, support care to women and families living in urban slums of Kenya, and prepare midwives to reduce the mother-to-child transmission of HIV in Southern African countries. The great majority of these professionals are native residents in the countries where we work.

My travel building cherished relationships with new colleagues from around the world has convinced me that we have more in common than one may think. For example, we all seek to build a stronger health care system that respects the autonomous role of the midwife. We all want midwives and other health care professionals to have the best possible work environment and access to the equipment and supplies needed to do their jobs. We want midwives to have a quality education that forms the foundation for life-long learning and growth.

Even our challenges, while apparent on a different scale in low resource countries like Afghanistan, are largely the same. We all struggle to find the resources to educate our midwives and offer them a living wage for their services. We work to develop autonomous regulatory structures that provide midwives with a framework for optimal practice. We strive to optimize midwives’ work environment so that they can maximize their effectiveness in practice. Even in America, where midwives often serve the most vulnerable of society’s women, these struggles are apparent. There are far too few of us because of our inability to overcome these challenges, and women suffer because of it. Let us use this week to celebrate midwifery globally while mobilizing our midwives here at home to overcome our shared challenges. Let us reflect on the lessons learned by midwives around the world that can “mainstream” midwifery practice in America.

Happy National Midwifery Week! Have You Thanked Your Midwife Yet?

It’s National Midwifery Week 2010! To help you celebrate, we’ll be posting more frequently this week. Check back often and don’t forget to take advantage of our National Midwifery Week resources.

Birth, Trust, and Cultural Divides
by Lorene Gilliksen, CNM

As I celebrate my daughter’s 26th birthday, I’d like to acknowledge the help I received during my pregnancy from Mei Ka Chin, my midwife. Emily is my only child, so I suppose I am 26 years postpartum.

When I was pregnant, I worked at North Central Bronx (NCB) Hospital as a staff midwife. Mei Ka was a lead midwife there, and my friend and neighbor. As a patient, I felt confident and well-cared for because I knew that I had Mei Ka’s complete attention.

We are all thankful for midwives who listen to women and extend the values of midwifery into communities worldwide. Mei Ka is special because she listens beyond and across cultural infrastructures. She puts the dislocated, fretful, and disenfranchised at ease. Only later, as I worked at a hospital that served immigrants to the Midwest, did I think about Mei Ka’s special skills. As I attended the births of women from several continents, I thought about the courage required to give birth in a foreign city, without one’s mother, and without one’s mother tongue.

As current research on pitocin and trust reminds us, a woman needs to feel safe in order to labor. Childbirth generates a ripple effect of trust. These ripples of trust are a woman’s confidence in her body’s ability to do the work, the relationship she has with her partner, the web of immediate family support, and wide social networks. Midwives facilitate the effectiveness of these relationships. Mei Ka recognizes how each ripple contributes to a woman’s sense of safety.

Mei Ka has devoted her life to being present with women. (The word midwife means “with woman.”) She is now in Shanghai bringing new life into one of the world’s biggest cities. Mei Ka Chin wears a cell phone around her neck. She’s on call all the time. She was on call 26 years ago. She is on call now. Thanks, Mei Ka!

ACNM Members: Read the full version of Lorene's essay in the upcoming fall issue of Quickening.

Let’s Play Catch Up!

by Melissa Garvey, ACNM Writer and Editor

We’ve been quiet at Midwife Connection lately, so let’s pick up the pace again by catching up on the latest ACNM news.

• Flu season is on the way. ACNM, CDC, and other professional organizations issued a joint statement on the importance of seasonal flu vaccination—especially for pregnant and postpartum women.
  
  
• Collaborative practice between midwives and physicians is in the spotlight. ACNM and the American College of Obstetricians and Gynecologists are calling for papers on successful collaborative practice models between midwives and physicians. Winning submissions will receive monetary awards and may be published in Obstetrics & Gynecology.
  
  
• Free updated midwifery fact sheets are available. Two of our most popular fact sheets—Essential Facts about Midwives and CNM/CM-Attended Birth Statistics—have been updated and are available online.
  
  
  
• National Midwifery Week is October 3 – 9. Host your own event or join in one of the many celebrations across the country during National Midwifery Week. ACNM has a webpage with tools to help you celebrate, and Where’s My Midwife? is organizing the National Walk for Moms and Midwives.
  
  

Supporters Join Forces to Save Terre Haute Midwives

by Melissa Garvey, ACNM Writer and Editor

A group of midwives at Union Hospital in Terre Haute, Indiana, have been notified that their employment contracts will not be renewed this year. It’s a familiar situation—one that we saw play out in Wilmington, North Carolina, about this time last year.

The midwives’ last scheduled day at the hospital is October 29, but a dedicated group of supporters is refusing to stand by as the date approaches. Prompted by outrage, their love of midwifery, and a little help from Where’s My Midwife?, Friends of Wabash Valley Midwifery have organized to fight for their community’s midwives. They are on their second letter to the hospital and their third action meeting. Meanwhile, their Facebook group has grown to 113 members who are prepared to picket if the group so decides.

Want to show your support for Terre Haute midwives? Here’s how to help:

• Join the Friends of Wabash Valley Midwifery group on Facebook and stay tuned to updates and calls for action.
• Organize or participate in a Where’s My Midwife? Walk for Moms and Midwives on Saturday, October 9, during National Midwifery Week.
• Sign the Save Our Midwives! petition.
• Help spread the word by sharing this post, the Friends of Wabash Valley Midwifery group, and the Walk for Moms and Midwives with coworkers, friends, and family.
  

How Do You Practice Real Midwifery?

by Leslie Ludka, CNM, MSN

Editor’s Note: In honor of National Midwifery Week, we asked Leslie Ludka to write an encore post based on her article “Are You Practicing Real Midwifery?” (click on the article for a sneak peak at Quickening, ACNM’s members-only newsletter!). Leslie is a regular columnist for Quickening and is Director of Midwifery at Cambridge Hospital and Birth Center in Cambridge, MA.

Whenever I think about midwifery as a career, I remember Sister Angela Murdaugh’s words: “Midwifery is a calling. If you do not believe that you were called, you should get out of midwifery.”

But, how do we know if we were called? Does it have to manifest in a specific type of job in a specific type of setting? Is it only a calling if we can’t wait to get up every morning and rush to work? Does being financially successful make it a calling?

I’m not sure about you, but for most of us, midwifery is neither easy nor lucrative. In fact, there are times when midwifery is the hardest job in the world—just ask any midwife to tell you the story of that case that haunts her memories. We all have one. In fact, there are times when our work is so difficult that no amount of money would attract most rational people.

So, why would anyone choose midwifery? I believe that Sister Angela has it right. Midwifery is not a choice; it is a calling. We do not choose midwifery; midwifery chooses us. When I went to midwifery school, I never asked if there would be a job for me when I finished. I didn’t wonder how much money I would make. I know it sounds crazy, but the truth is, it didn’t matter. Midwifery is my calling.

A calling fulfills your personal mission in life. It feeds your spirit by using your unique gifts and abilities to satisfy your deep inner purpose. Following your calling means staying on the path of that which you feel most passionate about, even when it is difficult. A calling is about truly loving what you do.

As we celebrate National Midwifery Week, let’s honor the diversity of this amazing calling of midwifery by sharing with each other and our supporters. Tell us, how has midwifery called you: clinical practice, education, administration, or something else? How do you live your calling?